Object : The purpose of this study is difference between western medicine and oriental medicine in tension headache. Methods : A literature study on the tension headache was performed. The cause, symptoms, relationship with other diseases, pathology and treatment of oriental and western medicine were investigated. Conclusion : In western medicine, tension headache is mainly caused by emotional stress, tension of head and neck musculatures. Treatments include medication, psychologic care, alteration of habits and biofeedback. Removal of muscle tension is of main interest in western medicine. In oriental medicine, tension headache is classified into internal and external problem. The imbalance of organs of spleen, liver and kidney causes headache. Hyperactivity of liver chi and deficiency of kidney yin are main source of headache. On the treatment, relieve of muscle tension and correction of bad habit are emphasized in western medicine while promotion of harmony among the internal organs is main target in oriental medicine.